Maria Kim, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

65123 Issued in CA

Practice address

15911 Pomona Rincon Rd Ste 120
Chino Hills, CA 91709-5567

Phone

(909) 497-9449

NPI assigned

Jan 20, 2016

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Priyawat and Kim Dental Services

  dba Omnia Dental Care

  • Oral and Maxillofacial Surgery Clinic/Center
  • Chino Hills, CA
  • NPI 1801461561

  General Practice

  Medicare reassignment NPD
• Ho Jung Kim DDS Inc

  dba M Dental Group

  • Dentist
  • Fullerton, CA
  • NPI 1023415684
  NPD (past)
• Jefferson and Chokka Dental Corporation

  dba Sierra Lakes Dental Group

  • General Practice Dentistry
  • Fontana, CA
  • NPI 1902003593
  NPD (past)
• Priyawat Dental Group Inc

  • Dentist
  • Chino Hills, CA
  • NPI 1689513483
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1053778241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15911 POMONA RINCON RD STE 120",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095567",
            "telephone_number": "909-497-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15911 POMONA RINCON RD STE 120",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095567",
            "telephone_number": "909-497-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARIA",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "65123",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "65123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Kim, DDS
• Jenny Kim
• Jin Young Kim, DDS, MS
• Karis Kim
• Lauren J Kim, PHARM. D.
• Michell Kim, OD
• Minkyong Kim
• Paul Chang Kim, PT, DPT
• Sang You Kim, M.D.
• Steven S Kim, DDS

• Oral and Maxillofacial Surgery (Dentist) in Chino Hills, CA
• Providers in Chino Hills, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.